title: Heterophilic antibody interference in immunometric assays.
abstract: Immunometric assays are inherently vulnerable to interference from heterophilic antibodies, endogenous antibodies that bind assay antibodies. The consequences of such interference can be devastating. In this review, we discuss strategies that reduce the damage caused by heterophilic antibodies. Clinicians should only order blood tests that are indicated for the patient and clinical setting at hand, and have the confidence to question laboratory results discordant with the clinical picture. Laboratorians should familiarize themselves with the vulnerability of the assays they offer, and be able to perform and interpret adequate confirmatory measures correctly. When designing immunoassays, the immunoassay industry should invest the necessary resources in specific protective measures against heterophilic antibody interference. Examples include using antibody fragments and the addition of effective blockers to assay reagents. The increasing use of modified monoclonal mouse antibodies both in therapy and diagnostics could present a particular challenge in the future.
authors.affiliation: Department of Medical Biochemistry, Oslo University Hospital, The Norwegian Radium Hospital, N-0424 Oslo, Norway. Electronic address: Nils.Bolstad@ous-hf.no.
authors.forename: Nils
authors.initials: N
authors.lastname: Bolstad
authors.forename: David J
authors.initials: DJ
authors.lastname: Warren
authors.forename: Kjell
authors.initials: K
authors.lastname: Nustad
mesh_terms: D000818:Animals; D000910:Antibodies, Heterophile / Q000097:blood* / Q000302:isolation & purification; D000911:Antibodies, Monoclonal; D006801:Humans; D007118:Immunoassay / Q000379:methods* / Q000592:standards*; D007141:Immunoglobulin Fc Fragments / Q000276:immunology; D051379:Mice; D012217:Rheumatoid Factor / Q000276:immunology; D012680:Sensitivity and Specificity
chemical_list: D000910:Antibodies, Heterophile; D000911:Antibodies, Monoclonal; D007141:Immunoglobulin Fc Fragments; D012217:Rheumatoid Factor
keywords: HAMA; heterophile antibody; heterophilic antibody; immunoassay; interference